| NPI | 1609045244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR LEE Member 325-695-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 23519) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-02-28 |