| NPI | 1326276205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY BULLOCK Owner/Dentist 972-222-5313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24312) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2009-06-30 |