| NPI | 1104847284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD NEIL REITER President 817-244-6315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 9697) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-08-22 |