| NPI | 1831607084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH JAMES PERRY Owner Member 210-349-3745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 13669) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 13669) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2018-02-20 |