| NPI | 1124342837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANDREW BABER Owner 479-464-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: AR 3594) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2011-09-27 |