| NPI | 1407925373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI KELLOGG Office Manager 281-557-8097 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 18906) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2024-01-02 |