| NPI | 1194226506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT ALAN DAVIDSON Dentist 479-442-5092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AR 2439) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2021-08-04 |