| NPI | 1215947304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S NELSON Dentist 479-521-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR AR3216) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |