| NPI | 1811733769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG HARRISON Owner / Provider 817-484-4778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-10-29 |