NPI | 1326564295 |
---|---|
Former Legal Business Name | COUNTRYMAN DENTISTRY, LLC |
Entity Type | Organization |
Authorized Contact | DALE BRYAN COUNTRYMAN Owner 972-231-2576 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2017-08-22 |
Last Update Date | 2025-09-04 |