| NPI | 1053663856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA J SPANN President 972-390-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 25560) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2014-09-03 |