| NPI | 1639861222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIVANI PATEL Manager 832-488-7187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2024-07-02 |