| NPI | 1346757960 |
|---|---|
| Former Legal Business Name | MICHAEL MABRY DDS PC |
| Entity Type | Organization |
| Authorized Contact | MELINDA BRITTON Treatment Coordinator 817-329-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 10892) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: TX 24577) |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2018-01-04 |