| NPI | 1003938333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED L. SPRADLEY President 817-294-5021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 11859) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |