| NPI | 1972896751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE DEANNE DAVIS Finance Manager 409-898-8602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 12088) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-05-26 |