| NPI | 1336365253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LOUIS REZNIK President 432-333-7105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 11123) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2008-06-12 |