| NPI | 1184061582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SVETLANA KONSTANTINOVNA SAMPSON Owner 214-790-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: ND 2105) |
| Enumeration Date | 2013-05-27 |
| Last Update Date | 2013-05-28 |