| NPI | 1265794317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADELINA P MONTY Owner 281-416-4385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 18185) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: TX 27247) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-14 |