| NPI | 1962716969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVERETT CHAD EVANS Owner 940-808-1940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23695) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2014-12-05 |