| NPI | 1568854818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA WILLISON Member 972-566-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: TX 14298) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 17916) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2016-08-25 |