| NPI | 1386854644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND BARRY THORNTON Owner 662-842-0212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 3017) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |