| NPI | 1053762823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANIA IMPASTATO Practice Administrator 281-392-1130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |