Healthcare Provider Details

I. General information

NPI: 1437014545
Provider Name (Legal Business Name): PEAK DENTAL CIBOLO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 W FM 78 STE 101
CIBOLO TX
78108-4096
US

IV. Provider business mailing address

646 W FM 78 STE 101
CIBOLO TX
78108-4096
US

V. Phone/Fax

Practice location:
  • Phone: 737-295-5998
  • Fax:
Mailing address:
  • Phone: 737-295-5998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ADAM SMITH
Title or Position: OWNER
Credential: DDS
Phone: 530-415-5483