| NPI | 1205470416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAE-HYUCK KWAK President 832-566-3553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2020-04-18 |