| NPI | 1003901299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK VINCENT NICOSIA Owner 713-781-4072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 8564) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |