| NPI | 1912970989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN MERWIN President 731-668-8922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN 7090) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN 1512) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN 1445) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN 7775) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-08-22 |