| NPI | 1417398256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN MOORE Owner/President 501-351-0368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3843) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2013-07-09 |