| NPI | 1285698191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYN L BLANC-CARPENTER Business Manager 972-717-0077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 14777) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2020-08-22 |