| NPI | 1871002816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA FINLEY Office Manager 469-651-1776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 23985) |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2022-07-21 |