| NPI | 1841740602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY NGUYEN Part Owner 832-620-5630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23417) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 23443) |
| 1223G0001X Dentist, General Practice (Licence: TX 21866) | |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |