NPI | 1477213312 |
---|---|
Doing Business As | TEXAS DENTAL SPECIALISTS |
Entity Type | Organization |
Authorized Contact | GREGORY KOSTELAC Credentialing Specialist 719-372-5605 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2021-12-20 |
Last Update Date | 2022-07-26 |