| NPI | 1679671051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG T DAVIS Owner 870-932-0330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2024-10-21 |