NPI | 1417756818 |
---|---|
Entity Type | Organization |
Authorized Contact | NICOLE BOLLINGER Rcm 512-500-0302 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2025-03-10 |
Last Update Date | 2025-03-10 |