| NPI | 1962220590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JAE WOO LEE Owner 972-786-6920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-10-02 |
| Last Update Date | 2024-10-18 |