| NPI | 1003157694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE J SOHN Owner/President 817-431-8887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 20596) |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2018-05-01 |