NPI | 1528683810 |
---|---|
Entity Type | Organization |
Authorized Contact | REBECCA VIRAMONTES Practice Manager 915-200-2645 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Enumeration Date | 2020-06-11 |
Last Update Date | 2022-07-08 |