| NPI | 1609197813 |
|---|---|
| Other Name | MAGNOLIA DIVISION |
| Entity Type | Organization |
| Authorized Contact | GARLAND REESE SHUFFIELD Business Manager 870-901-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2010-06-22 |