| NPI | 1528063831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY LANE WHITE President 817-731-2124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 20478) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2020-08-22 |