| NPI | 1225466329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE MANGAN Dentist 501-666-2801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: AR 2807) |
| Additional Taxonomies | 122300000X Dentist (Licence: AR 3929) |
| 122300000X Dentist (Licence: AR 3927) | |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |