| NPI | 1144312836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SHAYNE ISTRE Owner President 512-535-8911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2008-08-28 |