| NPI | 1639574064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RASHID BEIRUTE-PRADA Owner 972-412-0014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: TX 29058) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: TX 15087) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-28 |