| NPI | 1851904700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUYEN NGUYEN Owner 214-484-8560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |