| NPI | 1760575724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN ZUCARO Financial COO Rdinator 915-585-6373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 14024) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 14024) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2008-06-24 |