| NPI | 1841986999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN THOMAS CARLO Chief Executive Officer 214-521-5191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health |
| 1223E0200X Dentist, Endodontics | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2024-08-01 |