| NPI | 1871156109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIJAH CHANG WANG Orthodontist 469-455-1355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-06-11 |