| NPI | 1104215367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHESH B. GONDI President 903-257-8815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 22213) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 22213) |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2016-01-14 |