NPI | 1396622403 |
---|---|
Entity Type | Organization |
Authorized Contact | COREY STEVEN ROMERO Owner 318-787-1106 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2025-08-19 |
Last Update Date | 2025-08-19 |