| NPI | 1992900559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY DARLENE YOUNG Practice Manager 512-258-1636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 14399) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2020-08-22 |