| NPI | 1417150244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA RENEE GENTRY Owner 512-252-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 18637) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2008-10-29 |