| NPI | 1730328162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL L WHITTEN Owner 210-824-9488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 11391) |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2009-02-09 |