| NPI | 1497127450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RYAN YOST President 210-326-5546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 22842) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2015-10-29 |