| NPI | 1043664709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY LEWIS SKANCHY Orthodontist 385-210-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: UT 8702647) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2016-04-19 |