| NPI | 1659034270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE MANUEL GONZALEZ Owner 956-337-9505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2021-10-20 |