NPI | 1891407110 |
---|---|
Doing Business As | PROSPER TRAIL ORTHODONTICS |
Entity Type | Organization |
Authorized Contact | WILLIAM GRAVES Owner 806-353-1055 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2022-12-19 |
Last Update Date | 2022-12-19 |