| NPI | 1790490837 |
|---|---|
| Doing Business As | BLUE MOUND DENTAL |
| Entity Type | Organization |
| Authorized Contact | OMAR ALASSAF President 682-444-6813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-01-23 |