| NPI | 1679767248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN HUISMAN Owner 979-798-9103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 10723) |
| Additional Taxonomies | 133N00000X Nutritionist |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2007-08-28 |