NPI | 1073051777 |
---|---|
Doing Business As | WILLIAMS SQUARE DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | AMANDA LIGHTFOOT Authorized Representative 254-338-1468 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2017-02-02 |
Last Update Date | 2024-12-11 |