| NPI | 1215423090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE NGUYEN THAI Owner/Dentist 940-312-6939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2024-08-13 |