| NPI | 1114390705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP MICHAEL BARRON Dentist 817-732-1626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 31393) |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2015-11-05 |