| NPI | 1083172456 |
|---|---|
| Doing Business As | PARK GLEN DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | ASHLEY M CHAPA Front Office/ Rda 817-577-8831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2019-05-01 |