| NPI | 1487010591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUZ MARIA REESE Office Manager 817-500-5288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 12230) |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-01-05 |