| NPI | 1467621045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY R RHOADES Chief Financial Officer 682-885-4480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 22961) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2022-12-12 |