| NPI | 1346338654 |
|---|---|
| Other Name | PRIVATE CORP |
| Entity Type | Organization |
| Authorized Contact | RICHARD G SPARKS Dds 281-992-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 18708) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-22 |