| NPI | 1053316810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA LEA DENTO President 469-939-6116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2016-03-21 |