| NPI | 1497904080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTE KEITH COLLINS Owner 817-283-3777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 14170) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2008-09-18 |