| NPI | 1174043913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENA ANN FREEMAN Office Manager 830-625-4313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: TX 23997) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2022-07-21 |