| NPI | 1255794087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY SMITHERMAN Owner/Provider 979-777-3258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 28187) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |