| NPI | 1184892010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DELMAR MILLER President 270-885-0165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2008-04-02 |