NPI | 1811422942 |
---|---|
Doing Business As | INDIAN CREEK DENTAL |
Entity Type | Organization |
Authorized Contact | RICHARD SHAD HATTAWAY Owner 972-836-8653 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: TX 30158) |
Enumeration Date | 2017-04-26 |
Last Update Date | 2017-04-26 |