| NPI | 1225030455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MCGOUGH President 903-758-8770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 16925) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 16926) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2008-02-07 |