| NPI | 1851676027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT MILNER TATE Owner/President 512-346-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |