| NPI | 1740585256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND B FOURNIER Owner 281-331-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 12779) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 15400) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |