| NPI | 1699785923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES L. BEVANS President 501-224-4799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3542) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AR 3555) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: AR 1833) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |