| NPI | 1225405384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD HUTCHISON Owner 682-429-6339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 15049) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 15049) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2015-10-27 |