| NPI | 1518371442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON VICKERS Member 972-436-1513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 29795) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |