| NPI | 1629189774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN N GLENNON President 512-263-5034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 15791) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |