| NPI | 1871725739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL B WIEGAND Owner/Dentist 210-495-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2009-08-11 |