| NPI | 1437908969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM BENHAM Owner 469-231-6672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-05-16 |