| NPI | 1972487593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY TANNER MOUNT Owner 512-508-6104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-08-05 |
| Last Update Date | 2025-08-05 |