| NPI | 1699003566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA A LEBLANC Bookkeeper 409-838-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 7324) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 10524) |
| Enumeration Date | 2009-12-03 |
| Last Update Date | 2009-12-03 |