| NPI | 1881986008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES RICHARD POLSON Director 817-283-0025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 14974) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2011-05-05 |