| NPI | 1699661405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL RICHARDSON Director Revenue Cycle Management 214-934-7995 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2025-06-17 |
| Last Update Date | 2025-06-17 |