| NPI | 1407062193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA ALANA FLYNN Director 210-822-7002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 20683) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |