| NPI | 1457526014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENELOPE BUSTOS Dentist 972-233-2341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23247) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |