| NPI | 1730419391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON A CLAPP Owner 940-484-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 19950) |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2023-01-11 |