| NPI | 1083041529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN DANA RUTHERFORD Owner 432-367-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 13393) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2014-02-27 |