| NPI | 1194120881 |
|---|---|
| Former Legal Business Name | MAGIC DENTAL |
| Entity Type | Organization |
| Authorized Contact | BRIAN PHAN Dds 281-232-1421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 22313) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2014-10-29 |