| NPI | 1831324540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC RYAN SMITH Owner 512-989-7855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: TX 19812) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2009-05-26 |