| NPI | 1225191299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MENAPACE DELCLOS Responsible Officer 281-261-2504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 17351) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |