| NPI | 1407209745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL M HUFFAKER Owner 385-245-8247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 98296579922) |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2017-05-04 |