| NPI | 1972761450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH AARON CREVOISIER President 210-494-4978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 7663) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2008-05-30 |