| NPI | 1720523186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY ESPINOZA Office Manager 817-785-3290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2017-03-03 |