| NPI | 1013457746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AFUNRHE OGHRE-IKANONE CEO 314-600-2775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 30717) |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-04-11 |