| NPI | 1013629583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZAKARI TAYLOR Dentist/Owner 270-293-1683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2022-12-15 |
| Last Update Date | 2023-08-11 |