NPI | 1649346263 |
---|---|
Former Legal Business Name | COMMERCE ST FAMILY DENTAL CENTER PC |
Entity Type | Organization |
Authorized Contact | ALFRED GWINN BRADFORD CEO President Chairman Of Board 210-225-4867 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 08923) |
Enumeration Date | 2006-11-27 |
Last Update Date | 2007-10-25 |