| NPI | 1023277746 |
|---|---|
| Doing Business As | DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | LARNELL W DAVIS Executive Director 870-543-2380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-06 |