| NPI | 1316334113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES B MCKENZIE Owner 940-808-1970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27638) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2016-07-18 |