| NPI | 1508088824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKY G CAPLES Owner 318-325-9655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 4409) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |