| NPI | 1649546888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA M SCHRADER Administrator 806-745-8413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 16874) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2013-05-16 |