| NPI | 1548035827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN A WEDDING Owner 270-683-0275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-11-16 |
| Last Update Date | 2023-12-06 |