| NPI | 1790910776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROON NONE ISMAILI Owner 817-466-8080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 24439) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2009-05-20 |