| NPI | 1669714721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOD DAVID MOORE President 254-836-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22305) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |