| NPI | 1083239438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN ROBERTS Owner 580-541-6548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2020-10-12 |