| NPI | 1518418656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS A CARMICAL Owner/Provider 479-855-3313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2024-08-12 |