| NPI | 1598099541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA MALDONADO Owner 210-614-3898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 22977) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 8261) |
| 124Q00000X Dental Hygienist (Licence: TX 4540) | |
| 124Q00000X Dental Hygienist (Licence: TX 12877) | |
| 124Q00000X Dental Hygienist (Licence: TX 13272) | |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2016-08-31 |