| NPI | 1760500078 |
|---|---|
| Doing Business As | JACK SANSING DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | JEANNIE NELSON Director Of Dental Services 512-900-3471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2016-05-19 |