NPI | 1366644635 |
---|---|
Entity Type | Organization |
Authorized Contact | HAROLD N WILLMUTH Doctor 870-886-6761 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 1755) |
Enumeration Date | 2007-05-31 |
Last Update Date | 2020-08-22 |