| NPI | 1942646575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYADA ALTAMIMI President/ Dentist 469-688-4772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 22981) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2013-05-22 |