| NPI | 1336959774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ASHLEY President And Secretary 501-208-1593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-08 |