| NPI | 1033550983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG RANDOLPH Dentist 210-344-9898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 12316) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2013-07-08 |