NPI | 1063755437 |
---|---|
Entity Type | Organization |
Authorized Contact | ALYSSA AGUILAR Director Of Revenue & Credentialing 817-466-8554 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 24272) |
Enumeration Date | 2013-04-03 |
Last Update Date | 2021-03-04 |