| NPI | 1982988614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKY TODD SHORT Secretary/General Dentist 806-374-8011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX TX19351) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2011-09-29 |