| NPI | 1295863207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRADY W. BRYAN President 325-944-3565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 14472) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |