| NPI | 1558589002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A ROY President 270-821-3423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2008-05-16 |