| NPI | 1023846912 |
|---|---|
| Doing Business As | DENTAL 84 |
| Entity Type | Organization |
| Authorized Contact | ANTONIO CASTELLANOS VEJAR Provider 664-764-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-07-23 |
| Last Update Date | 2024-07-23 |