| NPI | 1316728363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS ISING Owner Orthodontist 270-769-2186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-10-06 |
| Last Update Date | 2023-10-06 |