| NPI | 1689030876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BRYAN GULLEY Owner / Oral Surgeon 361-992-3873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223P0300X Dentist Periodontics |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2021-11-11 |