| NPI | 1134919921 | 
|---|---|
| Other Name | BARNDENTIST | 
| Entity Type | Organization | 
| Authorized Contact | SUSAN SHULTS Practice Administrator 210-824-4621 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2025-05-07 | 
| Last Update Date | 2025-05-19 |