Provider Demographics
NPI:1275936874
Name:FONT RYTZNER, ANDREA ANNA (DDS, MSD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ANNA
Last Name:FONT RYTZNER
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9822 POTRANCO RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-9607
Mailing Address - Country:US
Mailing Address - Phone:210-543-8000
Mailing Address - Fax:
Practice Address - Street 1:9822 POTRANCO RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-9607
Practice Address - Country:US
Practice Address - Phone:210-543-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-27
Last Update Date:2014-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX304831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics