| NPI | 1912339151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M KING HARDY Manager 281-446-7353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 14308) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: TX 25506) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2013-07-30 |