| NPI | 1013275585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY VARGAS Inusrance Coordinator 817-834-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 15987) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2012-05-02 |