| NPI | 1346679719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID SU FONG WAN Dentist/Owner 281-647-6687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 22550) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2013-11-06 |