| NPI | 1831324052 |
|---|---|
| Former Legal Business Name | CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. |
| Entity Type | Organization |
| Authorized Contact | GLADYS JOHNSON WHITTEN Oral & Maxillofacial Surgeon/ Pres. 806-535-0238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 11953) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2014-10-01 |