| NPI | 1194021154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAZMIN NOLEN Executive Assistant 972-982-8490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22958) |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2011-02-08 |