| NPI | 1801256797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT CLINTON Dentist/Owner 972-937-4370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 19151) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 19151) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2017-11-07 |