| NPI | 1497078539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARI SHUTLER Office Manager 972-596-9242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 16343) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 11860) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 11521) | |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2010-03-03 |