| NPI | 1750088571 |
|---|---|
| Doing Business As | MY DENTAVILLE |
| Entity Type | Organization |
| Authorized Contact | MANSI SHAH Owner 469-400-3163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-02-13 |