| NPI | 1881799021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN C SIMONS President 512-444-3494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-08-22 |