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General NPI Number Information
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NPI Number | 1093297749
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Entity Type | Organization
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Legal Business Name | ALAMO CITY FAMILY DENTISTRY, PLLC
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Dates
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Enumeration Date | 08/29/2018
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 2397 NW MILITARY HWY STE C
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City | SAN ANTONIO
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State | TX
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Zip | 78231-2543
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Country | US
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Telephone | 702-204-7445
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 NE LOOP 410 STE 130
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City | SAN ANTONIO
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State | TX
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Zip | 78209-1613
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATYLEYDIS DEL PINO CARO
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Credential |
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Telephone | 702-204-7445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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