NPI | 1235415589 |
---|---|
Doing Business As | CLEAR LAKE MODERN DENTISTRY AND ORTHODONTICS |
Entity Type | Organization |
Authorized Contact | MATTHEW HENEHAN Owner Doctor 281-990-9400 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2011-11-01 |
Last Update Date | 2013-12-31 |