| NPI | 1588940928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY TUCKER Office Manager 940-387-0823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 8687) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2011-10-31 |