| NPI | 1861379893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL RICHARDSON Director Of Rcm 214-934-7995 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-08-20 |
| Last Update Date | 2025-08-20 |