| NPI | 1700103959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAN VIVIAN NGUYEN President 817-657-2818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22908) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2014-12-15 |