| NPI | 1659539708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM A FOWLER Owner/ Office Manager 936-564-9401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2008-05-27 |