| NPI | 1790047702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA NAVARRO Manager 832-689-6311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: TX 24787) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-14 |