NPI | 1124763271 |
---|---|
Doing Business As | DOCS DENTAL TRAVIS AFB |
Entity Type | Organization |
Authorized Contact | AMANDA EVANS LANCE Credentialing Specialist 910-728-9767 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2022-05-03 |
Last Update Date | 2022-09-01 |