| NPI | 1184879579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ALLAN LEACH Owner 915-751-0123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23711) |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2014-12-04 |