| NPI | 1932436326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER S. CAMPOS President 210-523-6188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 16042) |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2013-04-23 |