| NPI | 1790036150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEE BRITT Practice Administrator 806-792-6291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2016-04-20 |