| NPI | 1750830402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD SMITH President 830-629-1954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 16539) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 20481) |
| 122300000X Dentist (Licence: TX 22763) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: TX 29686) | |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |