| NPI | 1073064465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN KRIEGER Manager 972-899-1465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 30523) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |