| NPI | 1003045246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLY WAYNE MILES Owner 817-370-1314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 14,222) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2009-07-09 |