| NPI | 1316049851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILENE LOUISE REES President 325-949-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2019-08-28 |