| NPI | 1952431371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BALLARD President 817-367-6453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 20905) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: TX 16535) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2008-03-11 |