| NPI | 1336268861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRINA VIKTOROVNA SHULYAK Front Desk Worker 972-398-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 21723) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |