| NPI | 1366939340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAOLA RAMOS Credentialing COO Rdinator 972-869-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN DS9797) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2024-04-02 |