NPI | 1104361781 |
---|---|
Doing Business As | GENESIS PRIMECARE |
Entity Type | Organization |
Authorized Contact | CARLA ROADCAP CEO 903-927-3782 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 122300000X Dentist |
1223G0001X Dentist, General Practice | |
Enumeration Date | 2017-01-05 |
Last Update Date | 2023-08-28 |