| NPI | 1275352387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN SHORT HANSON Manager/Member 832-746-7862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2024-10-07 |