NPI | 1972711794 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNIE HA LUONG Regional Manager 817-457-4141 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: TX 18994) |
Enumeration Date | 2007-05-18 |
Last Update Date | 2007-08-17 |