| NPI | 1275904641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHESH BABU GONDI President 972-750-0610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 22213) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2016-02-03 |