Provider Demographics
NPI:1952315038
Name:REYES RETANA, ANA (DDS)
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:
Last Name:REYES RETANA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14855 BLANCO RD STE 413
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7731
Mailing Address - Country:US
Mailing Address - Phone:210-884-7805
Mailing Address - Fax:210-408-6001
Practice Address - Street 1:14855 BLANCO RD STE 413
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-7731
Practice Address - Country:US
Practice Address - Phone:210-884-7805
Practice Address - Fax:210-408-6001
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22930122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX22930OtherTEXAS LICENSE