| NPI | 1871819292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES R PAYERLE Owner 817-568-6811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 0023735) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2010-04-09 |