| NPI | 1659922904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIA HODGE Owner/Manager 501-916-2545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2019-09-26 |