| NPI | 1558695601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE ELIZABETH BARNES Owner 479-871-3801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AR 3678) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2009-09-22 |