| NPI | 1609153188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN R WALDER Orthodontist/President 972-215-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2011-11-10 |