| NPI | 1518477751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADY R ATKINS President/Owner 979-846-1813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 20564) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: TX 32980) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2021-12-28 |