| NPI | 1376652248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUPAKIT PEANCHITLERTKAJORN Owner 214-456-8825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 21159) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |