| NPI | 1891462479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY UDELL Office Manager 210-402-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2021-08-23 |