| NPI | 1427145622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNY HUGH DICKEY President 662-842-1735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2006-10-07 |
| Last Update Date | 2020-08-22 |