| NPI | 1033858006 |
|---|---|
| Doing Business As | DENTAL REPUBLIC WEST AVE |
| Entity Type | Organization |
| Authorized Contact | SON TRAN President 972-747-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-05-30 |
| Last Update Date | 2022-05-30 |