| NPI | 1114292984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEAU SPARKMAN President 479-739-4999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 6347) |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2012-03-13 |