| NPI | 1508889478 |
|---|---|
| Doing Business As | NORTH LITTLE ROCK PEDIATRIC DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MARK E WILSON Co Owner 501-771-2990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AR 2793) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: AR 2817) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: AR 2700) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |