| NPI | 1275293821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK LIANG Dentist 832-316-0369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-12-22 |
| Last Update Date | 2022-06-14 |