| NPI | 1366682817 |
|---|---|
| Doing Business As | BASTROP FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | GENE GRESS Owner 512-461-4027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 13087) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 24336) |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2009-04-27 |