| NPI | 1598091191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENWOOD BURNELL JORDAN Owner 281-839-3202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 10518) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2009-11-02 |