| NPI | 1386147502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN J. PETERS Owner 512-600-3535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2018-03-14 |