| NPI | 1992323257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECILIA SIMMONS Owner 214-865-8319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-09-02 |