| NPI | 1114441755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA JEFFCOAT Office Manager 254-799-4867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 27552) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2017-07-26 |