| NPI | 1740989094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA ESTRADA Billing/Credentialing Manager 214-275-4808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2023-02-27 |