| NPI | 1669416475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA HENDRICKS Insurance Clerk 361-993-2290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2013-01-10 |