| NPI | 1699524041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER WILLIAMS Contracting Manager 210-695-5004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2024-05-17 |