| NPI | 1518494384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARICRUZ S. MARTINZ General Dentist 254-214-5039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OK 6832) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: OK 6142) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |