| NPI | 1720008568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A KENNEDY President 361-992-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 8445) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 8445) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 8445) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-11-06 |