| NPI | 1477808442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUJATHA TELLA Director 214-620-7445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23445) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |