| NPI | 1811740921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY G. GOGGANS President 817-988-3476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2024-04-09 |