| NPI | 1346756103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WESLEY BORENGASSER Dentist 479-242-3340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AR 3525) |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2017-12-15 |