| NPI | 1033385497 |
|---|---|
| Doing Business As | MIDWAY FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | STEFANUS H SISWANTO President 214-934-2198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22440) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2008-05-06 |