| NPI | 1003702804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL RICHARDSON Director Revenue Cycle Management 214-934-7995 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-06-17 |
| Last Update Date | 2025-06-17 |