| NPI | 1891918827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P. STELLA President 817-927-1325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2014-01-15 |