| NPI | 1255072351 |
|---|---|
| Doing Business As | EL PORTAL DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JERIT DAVIS Owning Dds 214-491-8398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-04-05 |