| NPI | 1346310372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA ANNE BANKER Owner 210-494-4699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 10762) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2014-10-24 |