| NPI | 1366643496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDIE DUTTON Administrative Assistant 830-981-9193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 17072) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2009-02-26 |