| NPI | 1376832048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH GASKINS Insurance Planning Manager 254-899-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 15267) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2011-04-04 |