| NPI | 1124258041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL TRUEBLOOD Director 512-892-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2009-07-27 |