| NPI | 1922274943 |
|---|---|
| Former Legal Business Name | WESTSIDE DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | BRAD M EVERITT Dentist / Owner 361-883-4785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 15405) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2012-11-05 |