| NPI | 1578868188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH GASKINS Insurance Planning Manager 877-875-7408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS 3022-97) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |