| NPI | 1295942431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD L. INGRAHAM President 361-992-4746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 8441) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |