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General NPI Number Information
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NPI Number | 1598033581
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Entity Type | Organization
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Legal Business Name | CULEBRA SMILES AND ORTHODONTICS, PC
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 11010 W FM 471
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City | SAN ANTONIO
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State | TX
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Zip | 78253-4876
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Country | US
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Telephone | 210-688-9386
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Fax | 210-688-9058
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Provider Business Mailing Address
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Address Line | 2860 MICHELLE DRIVE 2ND FLOOR
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City | IRIVNE
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State | CA
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Zip | 92606
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Country | US
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Telephone | 714-368-2077
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Fax | 714-368-2092
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN S BARNES
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Credential | DDS
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Telephone | 210-688-9386
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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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