| NPI | 1790238103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA PULVER Member 281-392-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 31858) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2016-08-02 |