| NPI | 1952742470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL RIOJAS Hr 817-529-8151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: TX 23811) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 23811) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2013-07-12 |