| NPI | 1295846848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA SUE MILLER President 817-431-1115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 18589) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |