| NPI | 1518745488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSAMA SIDDIQUI Owner/Provider 214-493-1216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2023-09-20 |