| NPI | 1316360373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE L KETHLEY Owner 325-437-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 10328) |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2014-01-28 |