| NPI | 1427237866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA CROSSLAND Financial Coordinator 870-863-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 2321) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2021-04-02 |