| NPI | 1538512421 |
|---|---|
| Doing Business As | MODERY FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | JAKE MODERY President 806-731-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 30983) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: TX 30983) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2016-09-01 |