| NPI | 1154793982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN ANDREW BLANSETT Periodontist 479-631-6074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: AR 3958) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2015-10-20 |