| NPI | 1922576396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY JASON BUCHWALD Owner 972-377-5940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2018-11-05 |