| NPI | 1174115547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE M SIGNORINO Orthodontist 479-877-6565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2021-02-08 |