| NPI | 1790908390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY JENKINS Office Manager 281-427-5118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 13892) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-19 |