| NPI | 1255760120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA OSMER Office Manager 479-936-8877 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 3954) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2013-11-01 |