| NPI | 1235300872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA FAY HOBBS Credentialing Specialist 972-842-5707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 8495) |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2008-03-21 |