| NPI | 1063798718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL C MALLORY Orthodontist 817-562-3292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 20625) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2011-10-26 |