| NPI | 1215088877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH C SULLIVAN President 512-396-4288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 10995) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2021-03-11 |