| NPI | 1114222627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHALAKA ABHIJIT NESARIKAR Member Manager 972-241-1352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 21144) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |