NPI | 1194800987 |
---|---|
Entity Type | Organization |
Authorized Contact | RACHEL NITTINGER Manager, Credentialing 972-755-0816 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist |
1223E0200X Dentist, Endodontics | |
1223G0001X Dentist, General Practice (Licence: TX 18458) | |
1223P0221X Dentist, Pediatric Dentistry | |
1223P0300X Dentist, Periodontics | |
1223P0700X Dentist, Prosthodontics | |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
Enumeration Date | 2006-10-27 |
Last Update Date | 2017-11-20 |