| NPI | 1083856694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH GASKINS Insurance Planning Manager 817-416-7408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 24448) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2009-03-27 |