| NPI | 1336162510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD M WILEY III Vice President For Operations 361-853-8999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 14559) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-08-22 |