| NPI | 1225242464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW GRANT WILLIAMS President 870-856-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN 3392) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2008-01-09 |