| NPI | 1790094571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONI CROWDIS Office Manager 817-442-8282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 14732) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2010-09-28 |