| NPI | 1285811364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELONIE RACHEL DUTTON Owner 409-945-8080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 17982) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 17982) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2010-03-15 |