| NPI | 1316367600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY SIMPSON President 870-424-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 2912) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2014-04-24 |