| NPI | 1376840306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN T LE Owner/Dentist 817-793-0013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 21298) |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2011-02-28 |