| NPI | 1659966323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL ALEXANDER KENNEDY Owner/Doctor 361-992-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| 1223D0001X Dentist, Dental Public Health | |
| 1223G0001X Dentist, General Practice | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2021-12-15 |