| NPI | 1669691903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY GARCIA-ROCHA Senior Credentialing Team Lead 972-869-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD MD13793) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2025-08-26 |