| NPI | 1316224769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE LUIS MONTOYA President 901-340-4458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24453) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2011-11-14 |