| NPI | 1013289776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CHARLES CLINKSCALES Owner 409-866-9541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 15300) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2012-01-27 |