| NPI | 1740821420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH GASKINS Director Of Credentialing 972-869-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2019-10-03 |