| NPI | 1336595529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN RODEN-JOHNSON Owner 512-732-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 22109) |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2016-05-06 |