| NPI | 1528159076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN DAVID BLANCHARD General Dentist 972-394-1492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 14021) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |