| NPI | 1114018124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANKLIN SAMUEL BONASSO Oral Surgeon 512-320-1640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 18515) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |