| NPI | 1205860418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA ENGEL Owner 662-378-8645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS OR00677) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-07-12 |