| NPI | 1417598566 |
|---|---|
| Doing Business As | HERITAGE DENTAL STUDIO |
| Entity Type | Organization |
| Authorized Contact | JOEL R SKOUSEN Owner 469-535-6516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2019-09-30 |