NPI | 1003367533 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRISTOPHER WILSON Manager 432-682-0565 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 30926) |
Enumeration Date | 2016-10-19 |
Last Update Date | 2023-03-21 |