| NPI | 1770633257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI SMITH Manager 817-477-9283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 12577 11979 12225) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |