| NPI | 1255638243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANNA BUSH OLIVER General Partner 936-539-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 21852) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 11570) |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2011-02-28 |