| NPI | 1316013436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEYLA LORD President 972-904-9248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22028) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 22028) |
| 122300000X Dentist (Licence: TX 22028) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2016-05-11 |