| NPI | 1447886619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LASSETER Financial Coordinator 903-534-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2020-03-19 |