| NPI | 1174404537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY M LEBLANC President 281-989-4320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-09-10 |
| Last Update Date | 2025-09-10 |