| NPI | 1881101301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN N SMITH Owner 512-303-4545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-01-05 |