| NPI | 1982931564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY L HICKEY Insurance Billing/Collections 210-520-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22472) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2009-11-03 |