NPI | 1821262601 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNY GARCIA-ROCHA Senior Credentialing Team Lead 972-869-3789 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TN 8151) |
Enumeration Date | 2008-04-14 |
Last Update Date | 2025-07-29 |