| NPI | 1407198369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS L. PHILLIPS. JR. Owner 817-335-1125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 13496) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2013-03-19 |