| NPI | 1013382001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE R. BROWN Director Of Business Development 817-625-1548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2015-12-02 |