| NPI | 1558742593 |
|---|---|
| Doing Business As | STARLIGHT DENTAL AND ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | JED CODY NIELSON Provider 512-250-8101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2015-06-16 |