| NPI | 1558743872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R BROWN Business Manager 806-797-1275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 23079) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 23079) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2015-06-23 |