| NPI | 1245770148 |
|---|---|
| Other Name | WILLOWBROOK MALL DENTAL |
| Entity Type | Organization |
| Authorized Contact | VLADA MATYTSIN Owner/Dentist 281-955-5558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 30466) |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2017-02-27 |