| NPI | 1134720337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A BENAGE General Dentist 972-786-4307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-09 |