| NPI | 1962389007 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KRYSTAL RICHARDSON Director Of Rcm 214-934-7995  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | 
| Enumeration Date | 2025-08-20 | 
| Last Update Date | 2025-08-20 |