NPI | 1619398278 |
---|---|
Entity Type | Organization |
Authorized Contact | JOANNA AYALA Managing Member 210-632-4560 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 24255) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 24255) |
Enumeration Date | 2013-12-30 |
Last Update Date | 2013-12-30 |