NPI | 1336570654 |
---|---|
Entity Type | Organization |
Authorized Contact | RAYMOND BLAKE BRAIDFOOT Pediatric Dentist, Owne/Operator 972-566-6383 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 23666) |
Enumeration Date | 2013-12-12 |
Last Update Date | 2013-12-12 |