| NPI | 1447366323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP DWIGHT KOTHMANN President Of Corporation 325-942-9673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 11462) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2020-08-22 |