| NPI | 1750446712 |
|---|---|
| Doing Business As | NORTHSIDE DENTAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | TINA H NGUYEN Dentist 554-446-1350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |