| NPI | 1598810558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DRU BART BOURLAND Owner 325-695-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 18681) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |