| NPI | 1437493335 |
|---|---|
| Doing Business As | PEDIATRIC DENTISTRY OF EAST TEXAS |
| Entity Type | Organization |
| Authorized Contact | WARREN STACY GUY Owner 936-634-6119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX TX8431) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |