| NPI | 1750805602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI D MORGAN Practice Manager 469-296-8680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 19330) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 23867) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2022-07-21 |