| NPI | 1609145044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT FLEMING Registered Agent 972-690-8617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25656) |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2011-12-14 |