| NPI | 1447690276 |
|---|---|
| Doing Business As | IMAGINE DENTAL OF SOUTH LAREDO |
| Entity Type | Organization |
| Authorized Contact | BRADLEY RICHENS Owner 972-832-7825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2013-06-25 |