NPI | 1558770214 |
---|---|
Entity Type | Organization |
Authorized Contact | RAMSEY MATTHEW FANOUS Owner 806-794-0001 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX TX16343) |
Enumeration Date | 2014-08-07 |
Last Update Date | 2014-08-07 |