| NPI | 1114513256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DULCE Y DE JESUS Dentist 469-703-8030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| 1223E0200X Dentist, Endodontics | |
| 1223G0001X Dentist, General Practice | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0300X Dentist, Periodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 1223X2210X Dentist, Orofacial Pain | |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2024-09-23 |