| NPI | 1720526593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY MOON Managing Member 281-485-6003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 15404) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 28170) |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-02-01 |