| NPI | 1306317227 |
|---|---|
| Doing Business As | PRAIRIE STAR DENTAL |
| Entity Type | Organization |
| Authorized Contact | THOMAS RAWCLIFFE President 512-643-6104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-17 |