| NPI | 1689611527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDDY DALE MARTIN Dentist 817-238-6450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 13263) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-08-22 |