| NPI | 1427341502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN GREEN President 903-526-7366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 24237) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2011-07-08 |