| NPI | 1164540795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | E. WAYNE SIMMONS President 210-692-0136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: TX 22075) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 10836) |
| 1223P0700X Dentist, Prosthodontics (Licence: SC 1864) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |