| NPI | 1770706012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEPH MICHAEL MAHON President 210-614-3332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 19466) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 21951) |
| 1223P0700X Dentist, Prosthodontics (Licence: TX 19465) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |