| NPI | 1144876426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY DEPALMA Manager 940-387-0512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2019-08-13 |