| NPI | 1669640876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DOUGLAS GOSSETT Owner 830-625-6914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 17023) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 18816) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2019-07-02 |