| NPI | 1487511671 |
|---|---|
| Other Name | TRACE RILEY |
| Other Name | KATE DOBENS |
| Entity Type | Organization |
| Authorized Contact | KELLEY EASTER Office Manager 817-236-8771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2026-01-08 |
| Last Update Date | 2026-01-09 |