| NPI | 1225601610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN HILL Director, Rcm 972-930-7707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223P0700X Dentist, Prosthodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2021-07-22 |