| NPI | 1790218782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM GRAVES Owner/Doctor 806-353-1055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: TX 21838) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2017-04-06 |