| NPI | 1134463961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES IVAN WILLIAMS Owner 214-219-1159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 8495) |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2012-11-16 |