| NPI | 1003031527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON R HORNE Owner 903-758-6406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 18784) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 20796) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 13954) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |