| NPI | 1861651291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES IVAN WILLIAMS Owner 972-230-0155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 8495) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2008-06-11 |