| NPI | 1790140614 |
|---|---|
| Doing Business As | FAIR LAKES FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | PIERRE GHATTAS Owner/Dentist 281-712-2964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22621) |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2015-12-18 |