| NPI | 1770869018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELMA MOYA-FONSECA Office Manager 956-682-1284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 15380) |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2011-11-01 |