| NPI | 1225797467 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | PAUL A KENNEDY Doctor/Owner 210-971-6018 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice | 
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2021-12-15 | 
| Last Update Date | 2021-12-15 |