| NPI | 1801542790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID OMAR ZAMORA Chief Operations Officer 210-885-7634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 125Q00000X Oral Medicinist | |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2022-11-15 |