| NPI | 1689072233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT WILSON President 915-493-6310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: TX 24420) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2022-12-21 |