| NPI | 1629178801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETICIA G JEFFORDS Owner 210-692-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 18284) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2009-06-24 |