| NPI | 1780121798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JAMES ALLEN CEO 210-602-9831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 9332582-9921) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-01-27 |