| NPI | 1811013584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL ELIZONDO Owner 361-857-5494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 16184) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |