NPI | 1386090033 |
---|---|
Entity Type | Organization |
Authorized Contact | ALYSSA AGUILAR Director Of Revenue & Credentialing 817-466-8554 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 24272) |
Enumeration Date | 2016-05-12 |
Last Update Date | 2021-03-04 |