| NPI | 1457235285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIEN PHAN Managing Partner 210-921-0603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-08-04 |
| Last Update Date | 2025-08-04 |