| NPI | 1053668137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORLETTA TREJO Dentist 713-785-4867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 17954) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 19095) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2012-08-08 |