| NPI | 1811056112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM NEAL KRUGER President 979-774-1255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 13644) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 14532) |
| 1223G0001X Dentist, General Practice (Licence: TX 21962) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-08-22 |