NPI | 1497217590 |
---|---|
Entity Type | Organization |
Authorized Contact | MANDY L HOLLEY Owner 512-598-1517 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Enumeration Date | 2019-04-05 |
Last Update Date | 2019-04-05 |