Organization
CAPTAIN KIDS DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA AYALA (MANAGING MEMBER)
(210) 632-4560
Entity
Organization
Contact information
Practice address
17006 SAN PEDRO AVE, SAN ANTONIO, TX 78232-2231
(830) 772-4200
Mailing address
PO BOX 356, LYTLE, TX 78052-0356
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/03/2016
Last updated
11/03/2016
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