| NPI | 1073009049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH GASKINS Director Of Credentialing 972-869-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 203666) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2018-07-02 |