| NPI | 1134315252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBRA GAYLE GRIFFIN Owner/President 254-213-2170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: TX 23513) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2011-12-30 |