| NPI | 1265774319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY BINSTED Office Coordinator 870-572-9002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |