| NPI | 1508925769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER DANIELLE FERAY BOHAN Owner General Dentist 281-357-5002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 20540) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TX 101201) |
| 126800000X Dental Assistant | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-08-22 |