| NPI | 1447375704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BEATY Manager 972-727-7486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PR 18244) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |