| NPI | 1831927847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PONTRELLI Chief Operations Officer 832-203-7968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-22 |