| NPI | 1538660949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROD BRAZEAL Owner 817-731-6964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 27094) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-06-16 |