| NPI | 1629475306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MALONE Owner/Doctor 210-670-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-11-25 |