| NPI | 1508037128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN T. LE Dentist/Owner 817-426-3331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 21298) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 21298) |
| Enumeration Date | 2008-03-23 |
| Last Update Date | 2009-07-07 |