| NPI | 1659846970 |
|---|---|
| Doing Business As | 4405 DENTAL STUDIO |
| Entity Type | Organization |
| Authorized Contact | ANDREW EDMONDS Owner/Doctor 512-855-7308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2018-10-13 |
| Last Update Date | 2022-04-27 |