| NPI | 1629638085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG UECKERT Owner 512-345-3166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2020-11-18 |