| NPI | 1265472047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOMSON SUDHIVORASETH Dentist 972-633-2377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 20761) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2010-03-25 |