| NPI | 1326270208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD BRUCE NOVICK President/Owner 915-591-6676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV S3-62C) |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2009-08-11 |