NPI | 1598236796 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE TACKEL Office Manager 479-286-0040 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2018-12-16 |
Last Update Date | 2018-12-16 |