| NPI | 1578674446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT REX EATMON President 972-243-5035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 08875) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO 190) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |