| NPI | 1326488032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN H WONG Doctor/Owner 972-668-5608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 19058) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 19418) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-06-26 |