| Kaci L. Tibbetts | |
|
3223 Thousand Oaks Dr Ste #102 San Antonio TX 78247 | |
| (210) 496-5422 | |
| (210) 490-2388 |
| Full Name | Kaci L. Tibbetts |
|---|---|
| Speciality | Dentist |
| Location | 3223 Thousand Oaks Dr, San Antonio, Texas |
| Authorized Official Name and Position | Kaci Tibbetts (OWNER) |
| Authorized Official Contact | 2104965422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaci L. Tibbetts 3223 Thousand Oaks Dr Ste #102 San Antonio TX 78247 Ph: (210) 496-5422 | Kaci L. Tibbetts 3223 Thousand Oaks Dr Ste #102 San Antonio TX 78247 Ph: (210) 496-5422 |
| NPI Number | 1093068744 |
|---|---|
| Provider Enumeration Date | 10/18/2012 |
| Last Update Date | 06/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093068744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12844 (Texas) | Secondary |
| 122300000X | Dentist | 26455 (Texas) | Primary |
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