| NPI | 1316375876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN ELIZABTEH STANDEFER President 979-575-0406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24559) |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2013-10-21 |