| NPI | 1205128204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER WANG President 281-980-5090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 15601) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 14590) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2011-05-09 |