| NPI | 1376814582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID L BROWN Owner 817-283-2871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 11984) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 25569) |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2012-01-19 |