| NPI | 1568610061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAVIER BRISENO Dentist 210-656-6362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 14469) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2008-09-09 |