| NPI | 1174014245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYULEE SONG Managing Member 832-800-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 32449) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 33397) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-07-23 |