| NPI | 1063223592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER WILLIAMS Credentialing 806-353-1055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-01-15 |
| Last Update Date | 2025-01-15 |