| NPI | 1538606595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ROBERT SULLIVAN Owner 956-699-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 30177) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-01-27 |