| NPI | 1225497845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH JEFFERSON President 281-815-0932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 126800000X Dental Assistant |
| 251K00000X Public Health or Welfare | |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2016-02-11 |