| NPI | 1366155517 |
|---|---|
| Doing Business As | ACTIVE DENTAL PROSPER |
| Entity Type | Organization |
| Authorized Contact | KISHAN PATEL Owner 817-456-9342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2023-01-03 |