| NPI | 1942691597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD JOHN MARTIN Owner 972-434-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 20753) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |