| NPI | 1588783880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH REYNOLDS RAUB Owner 254-771-5701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 18253) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |