| NPI | 1649304767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY CARL JAYNES President Owner 972-491-3916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 17956) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |