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General NPI Number Information
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NPI Number | 1730327578
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Entity Type | Individual
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Provider Name | JOANNA CRISTINE AYALA D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 03/18/2015
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Provider Practice Location Address
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Address Line | 9902 MCPHERSON RD STE #25
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City | LAREDO
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State | TX
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Zip | 78045-6545
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Country | US
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Telephone | 956-725-3100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 356
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City | LYTLE
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State | TX
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Zip | 78052-0356
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Country | US
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Telephone | 830-772-5600
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 24255
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License Number State | TX
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