| NPI | 1518326750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHUNDA THOMPSON Owner 281-359-5551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0300X Dentist, Periodontics | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2016-02-16 |