| NPI | 1336483759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM TODD HEGMANN Dentist 903-701-1052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3907) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-30 |