NPI | 1659445997 |
---|---|
Former Legal Business Name | EL PASO ORTHODONTIC ASSOC PC |
Entity Type | Organization |
Authorized Contact | RICHARD C BLACK Owner Practicioner 915-592-5853 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 11053) |
Enumeration Date | 2006-11-20 |
Last Update Date | 2009-03-26 |