| NPI | 1104323856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH GASKINS Director Of Credentialing 972-869-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 28129) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |