| NPI | 1295474443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH HODAN Associate Operations Director 972-436-0008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2022-06-03 |