| NPI | 1073220422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ORTIZ DIAZ Sole Mbr 512-720-6612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-11-03 |
| Last Update Date | 2022-11-20 |