| NPI | 1699181909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL SIRIPHONGS Managing Member 903-885-3031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 29681) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2014-07-08 |