| NPI | 1720481278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA AYALA President 210-632-4560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 24255) |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2014-09-29 |