| NPI | 1114692209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY GOGGANS President 806-794-8124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2021-08-11 |