| NPI | 1427761196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI LEANN WALDSCHMIDT Chief Operating Officer 254-722-1083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-12-27 |
| Last Update Date | 2022-12-27 |