| NPI | 1275095770 |
|---|---|
| Doing Business As | BALCONES DENTAL |
| Entity Type | Organization |
| Authorized Contact | LISA LUNDERMAN Clinical Administrator 512-346-3427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2019-04-03 |