| NPI | 1740569144 |
|---|---|
| Doing Business As | ABC123 DENTAL |
| Entity Type | Organization |
| Authorized Contact | TRI H PHAM Owner/Dentist 817-656-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 24570) |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2011-08-16 |