| NPI | 1336301910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY S RIVERA Office Manager 817-281-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 10135) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2008-06-25 |