| NPI | 1942575618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH DEL BOSQUE Insurance Coordinator 972-599-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 18108) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2012-03-14 |