| NPI | 1104170331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDIO CAYCEDO Owner 214-794-1504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NM DD2385) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2012-11-09 |