| NPI | 1861106114 |
|---|---|
| Doing Business As | DENTAL FUN ZONE |
| Entity Type | Organization |
| Authorized Contact | ANTHONY KASALLIS Dentist 915-833-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-01-11 |
| Last Update Date | 2023-01-11 |