| NPI | 1255930798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRANAV MODY Owner 713-385-3019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-10-24 |
| Last Update Date | 2021-10-18 |