| NPI | 1831490226 |
|---|---|
| Doing Business As | ORTHODONTICS AT THE DENTAL AND IMPLANT SUITE |
| Entity Type | Organization |
| Authorized Contact | BRYAN ELVEBAK Owner/Partner 817-571-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 20522) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2011-03-02 |