| NPI | 1568534881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA L HEEP Office Administrator 479-633-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AR 2769,3578,3571) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |