| NPI | 1275841900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN E RUSSELL Financial COO Rdinator 479-474-9696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 3370) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-09-15 |