| NPI | 1649857962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE CARRANZA General Manager 281-256-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-04-22 |