| NPI | 1770716813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRASHANT M REDDY President 972-596-7474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 23534) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2009-08-24 |