| NPI | 1336410331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMEKA NICKLEBERRY CEO 832-654-2143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22283) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2012-01-23 |