| NPI | 1407187479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES IAN BALLOU Orthodontist 972-672-9279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 25102) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2011-05-11 |