| NPI | 1497360911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ANN VASQUEZ Operations Manager 512-892-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2020-09-16 |