| NPI | 1609954080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY WALLACE BALL President 281-488-6630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 12536) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-11-04 |