NPI | 1669779328 |
---|---|
Doing Business As | FUN DENTIST-SOUTH |
Entity Type | Organization |
Authorized Contact | CHARLES W. MILLER Owner 817-478-2300 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 9223) |
Enumeration Date | 2011-02-16 |
Last Update Date | 2023-09-12 |