| NPI | 1548534662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN VO Owner 512-345-4998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 21293) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 20243) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |