| NPI | 1366655078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA A LILES Patient Coordinator 479-582-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3251) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |