| NPI | 1770765679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YETUNDE O ABAYOMI Co Owner 817-477-2558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 21744) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 21998) |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2007-12-03 |