| NPI | 1902334535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME RIVERA Owner 915-585-7550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 22009) |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2017-05-26 |