| NPI | 1043027972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN ALLO Owner/Manager 469-835-3204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-12-13 |
| Last Update Date | 2024-12-13 |