NPI | 1043305170 |
---|---|
Entity Type | Organization |
Authorized Contact | CLOVIS ANDY KITCHENS President 501-223-0822 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AR 3186) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: AR 3512) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2020-08-22 |