| NPI | 1912712563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD RANDALL SMITH President 830-822-8633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-02-11 |
| Last Update Date | 2025-03-10 |