| NPI | 1386385086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMARON MARTIN Owner 210-962-6421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-04-05 |