| NPI | 1902178668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS KING DILLARD Member 469-766-8462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 13737) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2013-10-24 |