| NPI | 1235556036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEARL OLLYNE LAVERNE Office Manager 713-947-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 12508) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-03-19 |