| NPI | 1366511339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD FRANK ROD President 409-832-2532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 12382) |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: TX 12382) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2008-02-13 |