| NPI | 1902661325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABD AL HADI KAWAIAH Owner 469-434-9908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-02-15 |