| NPI | 1336541820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY BROWN Owner 817-431-6995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2014-09-16 |