| NPI | 1235909441 |
|---|---|
| Former Legal Business Name | LA VERNIA DENTAL |
| Entity Type | Organization |
| Authorized Contact | MARK A SIMMONS Owner/Manager 830-436-2155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-05-28 |