| NPI | 1396193694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BRYAN IOPPOLO VP 806-783-8837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: TX 22416) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-05-26 |