| NPI | 1922408194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENDRICK BASTIAAN TAFO-TABUE Owner 832-713-2497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401413401) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2014-08-25 |