| NPI | 1639489701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MICHAEL MILLER President 817-297-2271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 21257) |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2010-10-07 |