NPI | 1033750724 |
---|---|
Entity Type | Organization |
Authorized Contact | FAITH GASKINS Director Of Credentialing 972-869-3789 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2019-10-03 |
Last Update Date | 2019-10-03 |