| NPI | 1225196264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY W TREADAWAY Owner 972-875-6081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 12249) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-08-22 |