| NPI | 1801182852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY D TACKETT Office Manager 903-572-8543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 20928) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2011-06-28 |