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 |