| NPI | 1053899435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVERETT CHAD EVANS Owner/Dds 830-428-3698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23695) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |