| NPI | 1326280850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE HANSEN BAYLESS President 325-672-5988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 12014) |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2009-03-30 |