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 |