| NPI | 1972881894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON IP General Dentist 979-492-6589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 22988) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2013-05-17 |