| NPI | 1659687218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY GRAY Office Manager 936-295-5404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 14123) |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2014-04-09 |