| NPI | 1821503772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER VO Owner 817-656-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 24637) |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2024-03-19 |