| NPI | 1114058914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIAN CODEL Owner 214-642-5757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 16206) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 16206) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2011-02-16 |