| NPI | 1780197954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH AARON ENGLE Owner 765-210-6822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN 9853) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |