| NPI | 1316300460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY ANGER Dentist/President 385-229-4222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 4923760) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |