| NPI | 1255628582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN J GONZALEZ Owner Dentist 210-737-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22242) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2011-07-07 |