| NPI | 1689944688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN A. BENTLEY President 979-776-1838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 13303) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25626) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |