| NPI | 1285096982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL VILLARREAL Dentist 956-572-0049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 30290) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 30016) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |