| NPI | 1215342308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ANN OTERO President 939-644-7395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PR 3121) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2014-06-26 |