| NPI | 1679504518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LEE TYE President 817-552-3225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TX J2388) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2008-07-30 |