| NPI | 1538572961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL E MENTON Owner 817-265-3159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 25803) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2016-03-22 |