| NPI | 1477143444 |
|---|---|
| Doing Business As | 110 DENTAL & ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | FAITH GASKINS Director Of Credentialing 972-869-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2022-01-11 |