| NPI | 1013174879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM O. DAVIS Owner 956-631-5481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX D12719) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 21597) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2008-05-20 |