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General NPI Number Information
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NPI Number | 1538579495
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Entity Type | Individual
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Provider Name | DANIELA MARIE PUNZALAN D.M.D
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Gender | Female
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 7010 S ZARZAMORA ST STE 113
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City | SAN ANTONIO
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State | TX
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Zip | 78224-1148
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Country | US
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Telephone | 210-970-9158
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Fax |
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Provider Business Mailing Address
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Address Line | 504 E GRAVIS ST
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City | SAN DIEGO
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State | TX
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Zip | 78384-2708
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Country | US
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Telephone | 210-970-9158
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 30778
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | N0DI02580900
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License Number State | NJ
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