| NPI | 1215211917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RICHARD KELLOGG President 210-824-0203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 12028) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2011-09-30 |