| NPI | 1720682289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARNAZ NICKI TAJALLI President 713-963-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-11-25 |
| Last Update Date | 2024-07-10 |