| NPI | 1093920175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY ROBERTS ROWE Owner 870-932-4126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3341) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AR 3415) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2011-10-12 |