| NPI | 1457787970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME VILLARREAL Dr./Owner 972-722-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 22206) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 21771) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2015-08-28 |