| NPI | 1497130843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERVIN AMINI Credentialing Manager 713-465-8239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2021-08-05 |