| NPI | 1194157818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER NEILSON JEPPSEN Owner 479-524-9379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 3717) |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2013-08-05 |