| NPI | 1619738077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN GONZLEZ Owner 832-563-1956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-11-19 |