| NPI | 1558025247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL DEAN Vice President 214-293-8577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2022-11-16 |