| NPI | 1851616445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE HENRY Business Manager 512-258-8001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 15503) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 9890) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2010-04-07 |