| NPI | 1003351271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAYTON K COOK General Dentist 254-898-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 29154) |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2016-12-27 |