| NPI | 1841652799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUPAL DAVE Owner 817-741-0045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-03-21 |
| Last Update Date | 2021-04-13 |