| NPI | 1396189270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW D CARLISLE Owner/Periodontist 501-225-4644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: AR 3613) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2013-04-23 |