| NPI | 1760641856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN PAYNE ROBERSON Partner Dentist 512-869-5997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 14367) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 21726) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2008-06-04 |