| NPI | 1205291119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MICHAEL MOOSSY Owner 512-459-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 19487) |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2015-12-18 |