| NPI | 1346441102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FALLON ANTHONY DAVIS Owner 501-227-5567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 01863) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-08-22 |