| NPI | 1982003075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES M ALLEN Owner 361-854-7999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |