NPI | 1790354447 |
---|---|
Doing Business As | ROUTE 66 DENTAL IMPLANTS & PERIODONTICS |
Entity Type | Organization |
Authorized Contact | FAITH GASKINS Director Of Credentialing 972-869-3789 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics |
Enumeration Date | 2021-06-17 |
Last Update Date | 2021-06-17 |