NPI | 1225134828 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES JUBIN ANTONINI President/Owner 501-620-4677 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: AR 3158) |
Enumeration Date | 2006-09-15 |
Last Update Date | 2020-08-22 |