| NPI | 1043535727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON KYLE BENTON Clinical Director 479-265-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 3716) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2025-06-03 |