| NPI | 1336502210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY GARCIA-ROCHA Senior Credentialing Team Lead 972-869-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2025-05-08 |