| NPI | 1659502730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AFSHIN AZMOODEH President 972-644-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 20074) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 24260) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |