| NPI | 1790191492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN M ROBERTS Dentist 817-656-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 155870) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-07-02 |