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General NPI Number Information
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NPI Number | 1871553610
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Entity Type | Individual
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Provider Name | JOANA GUTIERREZ GANESHAPPA DDS
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Gender | Female
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4455 HARRY WURZBACH RD
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City | SAN ANTONIO
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State | TX
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Zip | 78209-2402
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Country | US
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Telephone | 210-822-4664
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Fax | 210-822-4878
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Provider Business Mailing Address
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Address Line | 10 WESTERLEIGH
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City | SAN ANTONIO
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State | TX
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Zip | 78218-1799
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Country | US
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Telephone | 210-381-1730
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 21268
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License Number State | TX
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