| NPI | 1417244054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADY KENT SMITH Owner 972-255-3712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 14695) |
| Enumeration Date | 2011-07-04 |
| Last Update Date | 2022-01-18 |