| NPI | 1548685100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS EARL YOUNGBLOOD Owner 214-718-2099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0300X Dentist, Periodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| Enumeration Date | 2014-02-19 |
| Last Update Date | 2014-02-19 |