| NPI | 1518602937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TO NGA THI DINH Owner 770-401-4719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| 1223E0200X Dentist, Endodontics | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2022-04-29 |