| NPI | 1649536244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS VAN DE WALLE President 512-878-2540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 21761) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2016-06-02 |