| NPI | 1760605414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY R GONZALEZ Orthodontist 210-344-9295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 5906) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |