| NPI | 1801123500 |
|---|---|
| Doing Business As | A TOOTH FAIRY'S PLACE |
| Entity Type | Organization |
| Authorized Contact | SANDRA DEE OLIVARES-GARCIA Owner 956-541-3624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 19135) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2009-11-17 |