| NPI | 1750697025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITA DESAI Member 214-517-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 21968) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2010-08-25 |