| NPI | 1457018947 |
|---|---|
| Doing Business As | GERIATRIC DENTAL GROUP |
| Doing Business As | FIFTY PLUS DENTAL |
| Doing Business As | GERIATRIC DENTAL GROUP OF SOUTH TEXAS |
| Entity Type | Organization |
| Authorized Contact | LYNN NOLF Registered Agent / COO 210-617-4446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2021-11-19 |