| NPI | 1346111986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA LIGHTFOOT Directory, Payer Relations 214-702-0708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-09-16 |
| Last Update Date | 2025-09-16 |