| NPI | 1568742641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY JOHN TOLLETT Director 713-622-3240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 27023) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2012-05-01 |