| NPI | 1316178684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A CAVAZOS Owner Physician 210-924-5008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 15230) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2009-08-04 |