| NPI | 1174081301 |
|---|---|
| Doing Business As | CONCHO VALLEY ENDODONTICS |
| Entity Type | Organization |
| Authorized Contact | CHAD R SOUTHARD Administrator 806-797-4455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2019-03-06 |