| NPI | 1417489634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER S CAMPOS President 210-349-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 16042) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-28 |