| NPI | 1568674620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN G STEPHENS Co Owner 903-561-7861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 9636) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 20671) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |