| NPI | 1720543580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUSTAVO SALAS Owner 713-955-2013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2019-02-06 |