| NPI | 1083263149 |
|---|---|
| Doing Business As | GREAT LIFE DENTAL |
| Entity Type | Organization |
| Authorized Contact | FAWZI HIJAZI CEO 210-821-5316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2020-04-14 |