| NPI | 1316086465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT F STANTON Owner/Operator 281-358-2997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TX 14816) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: TX 16440) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-04-03 |