| NPI | 1518313337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEJMAN KHOSRAVIAN CEO 512-722-6338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 25904) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 25904) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |