Gravis & Riley Family Dental Care | |
504 E Gravis St San Diego TX 78384-2708 | |
(201) 970-9158 | |
Not Available |
Full Name | Gravis & Riley Family Dental Care |
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Speciality | Dentist - General Practice |
Location | 504 E Gravis St, San Diego, Texas |
Authorized Official Name and Position | Daniela Marie P Punzalan (OWNER/ GENERAL DENTIST) |
Authorized Official Contact | 2019709158 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Gravis & Riley Family Dental Care 3130 Canaveral Dr San Antonio TX 78217-4007 Ph: (210) 970-9158 | Gravis & Riley Family Dental Care 504 E Gravis St San Diego TX 78384-2708 Ph: (201) 970-9158 |
NPI Number | 1346780566 |
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Provider Enumeration Date | 03/07/2017 |
Last Update Date | 03/07/2017 |
Identifier | Type | State | Issuer |
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1346780566 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 30778 (Texas) | Primary |