| NPI | 1023110194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE SANDOVAL Department Fiscal Administrator 210-207-5738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: TX 21503) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2012-11-27 |