| NPI | 1669741625 |
|---|---|
| Doing Business As | OWL CREEK SCHOOL BASED HEALTH CENTER DENTAL |
| Entity Type | Organization |
| Authorized Contact | KATHY GRISHAM Executive Director 479-751-7417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2011-12-21 |