NPI | 1912187428 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID MATTHEW MIKULENCAK President 817-923-5400 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 20876) |
Enumeration Date | 2007-11-13 |
Last Update Date | 2008-04-07 |