| NPI | 1922738913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN HAROLD WEBER Owner 512-627-7926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2022-06-13 |