| NPI | 1346344637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MICHAEL PHILLIPS Owner 903-892-0563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX D11445) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2020-08-22 |