| NPI | 1285868166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD REVERING President 972-355-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 18970) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2009-05-07 |