| NPI | 1245366491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY G CAILLETEAU Secretary 915-581-3391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 13443) |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2020-08-22 |