| NPI | 1891713863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT CORNELIUS President 817-431-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 19334) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2019-07-17 |