| NPI | 1417264524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SASAN KHODABAKHSH Dentist/Owner/President 972-735-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 22300) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2010-09-10 |