NPI | 1518520014 |
---|---|
Entity Type | Organization |
Authorized Contact | CHESTER LYNN HURST President 844-295-6915 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2019-04-19 |
Last Update Date | 2019-04-19 |