| NPI | 1013178268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES STEVEN WIDNER President 512-452-3223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 15113) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2011-09-07 |