| NPI | 1013458983 |
|---|---|
| Other Name | BAYBROOK MALL DENTAL |
| Entity Type | Organization |
| Authorized Contact | VLADA MATYTSIN Owner/Dentist 281-461-6515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 30466) |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-03-13 |