| NPI | 1396331435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DULCE Y DE JESUS Dentist 469-501-2660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| 1223X2210X Dentist Orofacial Pain | |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2024-09-16 |