| NPI | 1043864093 |
|---|---|
| Doing Business As | CONWAY REGIONAL INTERFAITH DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | WILLIAM PACK CFO 501-450-2112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2023-11-09 |