| NPI | 1548713688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN ROBERT PATRICK Owner 281-608-7535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 30790) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2018-11-10 |