| NPI | 1255667168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. CRAIG SCASTA President 979-260-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 20230) |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2009-10-28 |