| NPI | 1427968833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAELA MUNIZ VP, Payor Relations 469-324-3242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2026-09-09 |
| Last Update Date | 2026-09-09 |