| NPI | 1306178249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LYNN WEST Owner/Dentist 817-234-9378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 21325) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-02-03 |