| NPI | 1922482686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD ANDRESS Owner 281-738-1579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 6626) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223G0001X Dentist General Practice | |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223P0300X Dentist Periodontics | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 6626) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-07-13 |