NPI | 1144242736 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFERY C FUSILIER President 501-922-6700 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 2947) |
Enumeration Date | 2006-07-24 |
Last Update Date | 2018-06-21 |