| NPI | 1598041659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON BLACKWELDER President 254-772-8330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 22764) |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2011-11-02 |