| NPI | 1235833781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG ELLIS Dentist/Owner 817-370-7776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2023-04-04 |