| NPI | 1518233691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICKEY W LINDSEY President 870-836-7860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: AR 2816) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |