| NPI | 1124239066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEANN MIGYANKA BENNETT Director 972-462-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 19883) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |