| NPI | 1952459307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE MARIE WILKS Office Manager 903-758-3444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 10700) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2012-03-20 |