NPI | 1760157796 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREA CAROLINA VILLARREAL Credentialing Manager 210-495-2000 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2021-08-11 |
Last Update Date | 2021-08-11 |