| NPI | 1053743518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRISTI FLETCHER Orthodontist 817-479-0541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 19486) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 22279) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2013-11-04 |