| NPI | 1932431483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DAVID BURCHARD President 512-255-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2010-02-09 |