| NPI | 1548768930 |
|---|---|
| Doing Business As | FIESTA DENTAL |
| Entity Type | Organization |
| Authorized Contact | DARREN EARL BOGGS Chief Of Operations 940-368-1495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24348) |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2018-01-31 |