| NPI | 1518418656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS A CARMICAL Owner/Provider 479-855-3313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AR 2951) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2016-10-24 |