| NPI | 1518038728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL W. COOPER Owner 479-968-4477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 2569) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2020-08-22 |