| NPI | 1972885291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL L CANTU Insurance Specialist 817-571-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22290) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2011-09-13 |