| NPI | 1134498629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL ROBERTS Treasurer 479-650-3257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 2787) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2011-12-29 |