| NPI | 1932479383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MARK SIVLEY Owner/Partner 325-692-1580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 13811) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 23115) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |