| NPI | 1306425335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NARCE MEDRANO Office Manager 832-345-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-04-06 |