| NPI | 1265699425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL D MCCANCE Office Manager 870-793-4151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 2204) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2008-05-16 |