| NPI | 1366708760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORIA GUIATAS NAHATIS Owner / Dentist 817-428-7704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 21802) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-10 |