| NPI | 1629447495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY R BADGER Chair 713-486-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2015-09-22 |