| NPI | 1114593647 |
|---|---|
| Doing Business As | PRIME DENTAL OF LIBERTY HILL |
| Entity Type | Organization |
| Authorized Contact | DEEPAM TIWAN Access Manager 512-299-3806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2021-06-03 |