| NPI | 1306358668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA BROWN Director 817-440-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2017-10-26 |