| NPI | 1245468982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MOBLEY President 903-463-6013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX TX9690) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: OK TX9690) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2009-07-01 |