| NPI | 1366788689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BAK Regional Manager 936-447-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 343800000X Secured Medical Transport (VAN) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2025-06-16 |