| NPI | 1295891521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK RICHARD MALOCH Director 713-797-1731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 14951) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-08-22 |