| NPI | 1992137707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILY B HAILEMESKEL Owner/Manager 469-939-8219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 12891811) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2013-08-02 |