| NPI | 1659479574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNIE BRYANT Dds/Partner 870-226-6556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 2181) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AR 3480) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |