| NPI | 1942519632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERTHA ELIZABETH RODRIGUEZ Regional Manager 210-681-4867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 15889) |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2010-09-29 |