| NPI | 1922579473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON ELAINE DAVID Relationship COO Rdinator 817-900-3520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2018-12-10 |