| NPI | 1487871711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLIAN ADAME NELSON Dentist 956-542-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 18988) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 21228) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 22054) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |