| NPI | 1114101961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L. WOOLDRIDGE Sole Owner 210-824-7457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 12923) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2007-12-27 |