NPI | 1588909956 |
---|---|
Doing Business As | NONE |
Entity Type | Organization |
Authorized Contact | RONALD JENARD MOON President/Dentist 712-777-6453 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 19552) |
Enumeration Date | 2012-12-11 |
Last Update Date | 2012-12-11 |