| NPI | 1730265968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY HASSANZADEH Owner 817-451-9292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 16838) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 17911) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2008-12-29 |