| NPI | 1013392463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMPBELL BOURLAND Doctor/Owner 972-231-6661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 22690) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |