| NPI | 1689426397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN MORRIS Credentialing Manager 806-353-1055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223G0001X Dentist, General Practice | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2024-04-04 |