| NPI | 1558363036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYDE FAWCETT President 281-440-6648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 14301) |
| Enumeration Date | 2005-08-13 |
| Last Update Date | 2008-05-11 |