| NPI | 1720394935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLEN BLUME Dentist 210-614-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 20057) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2019-06-19 |