| 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 |