| NPI | 1265439699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN S ELVEBAK President 972-931-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 20522) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2018-03-17 |