| NPI | 1619220811 |
|---|---|
| Doing Business As | BRODIE OAKS DENTAL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL CIAVERELLI President 512-445-5866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2012-10-25 |