| NPI | 1588895692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY WILHELM WITTICH Owner/Dentist 512-565-6544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 22616) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |