| NPI | 1851108161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA EVANS FARR Owner 832-723-7151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2024-12-11 |