| NPI | 1568676427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY M WALTERS Owner 479-524-6441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 2458) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |