| NPI | 1104207653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGIO ENRIQUE LOPEZ Owner/Pediatric Dentist 956-212-3662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 27129) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2015-06-10 |