NPI | 1396174900 |
---|---|
Entity Type | Organization |
Authorized Contact | DORIS ZERCHER Office Manager 210-922-3483 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 27696) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 14060) |
1223P0221X Dentist, Pediatric Dentistry (Licence: WI 23705) | |
1223P0221X Dentist, Pediatric Dentistry (Licence: PA 25239) | |
Enumeration Date | 2013-11-04 |
Last Update Date | 2013-11-04 |