| NPI | 1760501944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY CARROLL BOLEY President 972-231-4896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 7425) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |