| NPI | 1770153876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACIE MILLS Member 806-786-4887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2021-06-30 |