| NPI | 1306557871 |
|---|---|
| Other Name | BRAZOS VALLEY DENTAL GROUP, LLC |
| Entity Type | Organization |
| Authorized Contact | BRIAN S BLACK Dentist / Owner 979-695-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2022-12-06 |