| NPI | 1013306158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY L BAKKER Owner/Doctor 479-751-8820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AR 2398) |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-01-13 |