Provider First Line Business Practice Location Address:
20306 ENCINO LEDGE STE 106
Provider Second Line Business Practice Location Address:
KIDDO DENTAL
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78259
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-495-6800
Provider Business Practice Location Address Fax Number:
210-495-6801
Provider Enumeration Date:
04/12/2011