| NPI | 1043648199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CASE Owner 979-776-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 12102) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 12102) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |