| NPI | 1568973089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA M CARUSO Office Manager 972-867-8882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 24177) |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2017-10-24 |