NPI | 1396814638 |
---|---|
Entity Type | Organization |
Authorized Contact | SCOTT ALAN MASON Ownerpartner 817-481-4717 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 17211) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 9032) |
Enumeration Date | 2006-11-08 |
Last Update Date | 2020-08-22 |