| NPI | 1912185703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM RALPH PHILLIPS Owner 469-689-0704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 19017) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2008-02-05 |