| 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 |