| NPI | 1356092324 |
|---|---|
| Doing Business As | LUBBOCK SALEM AVE |
| Entity Type | Organization |
| Authorized Contact | JEFF REIBEL CFO 502-254-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-08-17 |