| NPI | 1235538778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA KAY GAINES Dentist 479-936-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3098) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: AR 3098) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |