| NPI | 1649624362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA JASINA President 214-680-0443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CO DEN.00202786) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2016-04-19 |