| NPI | 1740761550 |
|---|---|
| Doing Business As | SOUTHFORK DENTAL |
| Entity Type | Organization |
| Authorized Contact | BINDU KOLLI Dentist 972-544-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 21085) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |