| Craniomandibular Associates Of San Antonio Pllc | |
|
5 Coughran Rd Ste 302 Boerne TX 78006-8103 | |
| (830) 446-5510 | |
| Not Available |
| Full Name | Craniomandibular Associates Of San Antonio Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5 Coughran Rd Ste 302, Boerne, Texas |
| Authorized Official Name and Position | Tara Lee Cully (CEO) |
| Authorized Official Contact | 8304465510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Craniomandibular Associates Of San Antonio Pllc 114 Upper Balcones Rd Boerne TX 78006-8545 Ph: (830) 446-5510 | Craniomandibular Associates Of San Antonio Pllc 5 Coughran Rd Ste 302 Boerne TX 78006-8103 Ph: (830) 446-5510 |
| NPI Number | 1093695660 |
|---|---|
| Provider Enumeration Date | 09/04/2025 |
| Last Update Date | 10/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093695660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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