| NPI | 1639353519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM P EASTMAN President 662-323-8065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS 1477-72) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2007-12-27 |