NPI | 1548872542 |
---|---|
Former Legal Business Name | FULL SMILE DENTAL, PLLC |
Entity Type | Organization |
Authorized Contact | WILLIAM EDWARD GRAVES Owner 806-353-1055 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2020-08-20 |
Last Update Date | 2023-11-27 |