| NPI | 1821219866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALCOLM RAY SCOTT President 512-371-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 15192) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |