| NPI | 1891911236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FRENCHETTA TUCKER President 254-778-1990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 16549) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |