| NPI | 1699262493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BLAIR Owner/Dentist 817-737-5155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-05-08 |