| NPI | 1952786402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYE ALAN THOMPSON Owner 432-687-0629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 29882) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2015-07-27 |