| NPI | 1093897951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESUS HECTOR TREVINO Dentist/President 956-781-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2010-07-15 |