| NPI | 1558538181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE SECREASE Office Manager 870-932-0330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 2621) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-06-10 |