| NPI | 1740326818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL BRENT BAILEY Partner 281-461-1982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2025-12-03 |