| NPI | 1144597931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAROM COOPER HEATON Owner 512-940-8601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2013-07-08 |