| NPI | 1245696822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN COZAD Owner 281-681-1118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 26507) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |