| NPI | 1114371804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARTON RANDALL SLOAN Pediatric Dentist 385-210-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 96759619923) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2016-04-19 |