| NPI | 1750640983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LAWSON BUCKLES President 972-596-0312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: TX 11254) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2012-05-08 |