| NPI | 1518379452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANN BROOKS Office Mgr. 501-982-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 2890) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |