| NPI | 1134538945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUSSADIQ IFTIKHAR Owner/Provider 281-781-6694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 28241) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 29720) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-06 |