| NPI | 1285021451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA MASK Office Manager 972-771-1117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 19930) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-04-24 |