| NPI | 1386041549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAVIN TROGDON Owner/Dentist 479-267-5009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3959) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2020-09-22 |