| NPI | 1487775011 |
|---|---|
| Former Legal Business Name | JOHNSTON LAWRENCE RIVER VALLEY PEDIATRIC DENTISTRY PLLC |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY WAYNE LAWRENCE Owner 479-783-4182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AR 3089) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2008-07-01 |