| NPI | 1144497504 |
|---|---|
| Doing Business As | CRYSTAL CREEK DENTAL |
| Entity Type | Organization |
| Authorized Contact | AN Q LE President 972-377-8866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 22204) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2008-05-14 |